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Few uninsured Louisiana residents signed up for Affordable Care Act coverage

BATON ROUGE – While more than 100,000 Louisiana residents signed up for health insurance under the Affordable Care Act, the push to enlist individuals and families into health plans largely missed the people who needed it the most.

That’s the conclusion reached by the Louisiana Hospital Association and WalletHub, an online personal finance advisor which released its 2014 Health Insurance Coverage Report showing that the vast majority of the 101,778 Louisianans who bought insurance through the program already had some type of coverage.

“A majority of them are not people who were uninsured,” said Paul A. Salles, president and chief executive officer of the Hospital Association. “They were moving from one coverage to another.

“We haven’t seen a noticeable difference” in the number of newly insured patients, he said. “It has not made a noticeable impact in Louisiana. The uninsured rate in Louisiana hasn’t changed much.”

Odysseas Papadimitriou, CEO and founder of Evolution Finance, the parent company of WalletHub and CardHub, said his company’s study found the percentage of uninsured in Louisiana dropped from 22.41 percent to 20.91 percent. That still leaves more than one of every five residents in the state with no insurance.

“Louisiana is the third worst in the country,” he said. “Louisiana did a lousy job with only 1.5 percent signing up.”

Falling behind Louisiana are Mississippi and Texas.

In Mississippi, where the percentage of uninsured increased during the sign-up period, the rate climbed from 18.11 percent to 21.46 percent.

Texas has the highest percentage of uninsured residents with 24.8 percent — almost one of every four residents – without coverage. That’s down from 26.8 percent prior to the Affordable Care Act becoming law.

“The only way states like Louisiana that have more people with lower income than other states can cut down on the number of uninsured is Medicaid expansion,” Papadimitriou said. “But Louisiana rejected expansion.”

Gov. Bobby Jindal rejected $16 billion in federal health care funding to cover 242,000 people who fall between the current income cutoff level for receiving Medicaid and being able to afford to purchase insurance.

Several have labeled that “the Jindal gap.”

Papadimitriou said that besides those people not being able to be insured, increasing medical costs for others, “taxpayers in Louisiana are paying for Medicaid expansion in California, New York, West Virginia and other states that accepted it.”

West Virginia was much like Louisiana with a high number of uninsured and people who would fall into the gap, he said.

But with a successful insurance enrollment and expanding Medicaid, West Virginia had the most success, cutting its uninsured rate from 17.34 percent to 6.59 percent — sixth best in the country.

Massachusetts, which had the lowest uninsured rate in the country at 4.35 percent, accepted expansion and now will have only 1.2 percent of its residents without insurance, the study shows.

Among the goals of expansion and enrolling patients in insurance plans were having them receive preventive care to help avoid serious illnesses and to stop so many people from using hospital emergency rooms as doctors’ offices,

Salles said that hasn’t happened in most places.

As of June, 26 states and the District of Columbia had implemented or were in the process of implementing Medicaid expansion, 21 rejected it and 3 were still considering it.

A map showing which states have rejected expansion shows a solid swath through the south, starting in Virginia and ending at the Texas-New Mexico border and running up through the central plains states. Arkansas, which received a waiver to implement some parts of expansion, is an outlier on the map.

It is yet to be seen what impact a new law passed this year will have on the uninsured rate.

Jindal signed into law a bill that its author, Sen. Ben Nevers, D-Bogalusa. That legislation, SB 682, reflects a plan Jindal proposed as an alternative to what is known as Obamacare. During the session it was referred to as “Jindalcare.”

The Department of Health and Hospitals by Sept. 1 is to draw up plans for implementing the program, which includes things like coverage of pre-existing conditions, portability of coverage, cross-state insurance purchasing, help affording premiums and reform of the way the state runs Medicaid.

The law provides that the state may implement cost-sharing and co-pays, as a condition of participation in the plan, for participants whose earnings exceed 50 percent of the federal poverty level.